Hallaton Manor Limited

Hallaton Manor Limited is a residential care home providing personal care for up to 41 people. The service provides support to a range of people some of whom may be living with dementia, people with mental health needs, people with a physical disability, people who misuse drugs and alcohol and younger adults. At the time of our inspection there were 38 people using the service. Accommodation is provided in one adapted building across 2 floors and has a mixture of smaller and larger communal areas and extensive gardens and grounds for people to use.

People's experience of using this service and what we found

Risks associated with people's care and support had been assessed. Records required further detail to ensure sufficient guidance was available to support staff to mitigate known risks. Daily monitoring records were not always completed consistently to demonstrate identified measures were followed to protect people from the risk of dehydration.

The registered manager and provider were responsive to feedback during and after the inspection and demonstrated some immediate improvements were undertaken. These included improvements to care plans and environmental concerns.

There were effective safeguarding systems in place and safeguarding concerns were managed promptly. Staff understood their responsibilities in relation to safeguarding and felt comfortable to raise concerns. People received their medicines safely and as prescribed.

The provider had improved the approach to infection prevention and control, undertaking refurbishment work and reviewing practices. There were sufficient staff to keep people safe; staff had been safely recruited and trained to provide consistency in care. People felt safe and relatives provided positive feedback.

People were supported to have maximum choice and control of their lives and to live in the least restrictive way possible and in their best interests; policies and systems in the service supported this practice.

The provider worked collaboratively across services to understand and meet people's needs, and people experienced positive outcomes regarding their health and well-being. The service had a positive culture that was person-centred and empowering. People, their relatives and staff spoke positively about the registered manager and felt involved with the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 June 2021) and we found a breach of regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had made improvements and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to good. This is based on the findings at this inspection

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hallaton Manor Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Hallaton Manor Limited is a residential care home providing personal care for up to 41 people. The service supports younger and older people living with mental health, dementia and who may have a history of substance or alcohol misuse. Accommodation is provided in an adapted manor house with vast external grounds. At the time of our inspection 34 people were using the service.

People’s experience of using this service and what we found

The provider had not consistently acted in accordance with the requirements of the Mental Capacity Act 2005 where people lacked mental capacity to make informed choices around their care and support. Best interest processes were not always followed.

Risk assessments required improvement. Not all known risks to people had sufficiently detailed and documented risk assessments in place. However, staff knew people well and knew what to do to keep them safe. Areas of the premises required remedial action to ensure the safety of people of using the service and timely redecoration.

The provider had systems in place to check the quality and safety of the services provided. However, not all the shortfalls we found during the inspection had been identified. There was no service improvement plan in place to evidence who was responsible for remedial actions and how and when these would be made.

Overall, people were protected from infection. However, the practice of using a shared hoist sling for a standing aid did not support effective infection control. The manager told us they would address this immediately following our inspection visit. Staff wore appropriate personal protective equipment and the home appeared clean and odour free.

People were protected from abuse, systems and processes were in place to identify and report any abuse or harm. People were supported by a consistent team of staff who knew them well. There were enough staff deployed to meet people's needs. Staff had been safely recruited, though this was not always evidenced in staff recruitment files.

People were supported to take their medicines safely and as prescribed. Staff encouraged people to eat and drink a balanced diet which took account of their needs and preferences. Staff ensured people had access to a full range of health and social care services to maintain their well-being.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (Published 20 January 2021)

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service experienced abuse. This incident is subject to further investigation. As a result, this inspection did not examine the circumstances of the incident. We undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hallaton Manor Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit. If we receive any concerning information we may inspect sooner.

Hallaton Manor is residential care home providing personal care to 41 people and accommodates older people, people with mental health issues, people with learning disabilities and autism, people with alcohol and drugs issues, people with dementia, people with physical disabilities and younger adults. At the time of our inspection there were 34 people using the service.

Accommodation is split over two floors accessed by a lift. Communal areas included lounges, dining rooms and adapted bathrooms. The home had a visitor pod for social distanced visiting, a farm shop and a separate hair salon.

People's experience of using this service and what we found

People we spoke with praised the home. People felt safe and well cared for.

There were sufficient numbers of staff employed to ensure people's needs were met.

Recruitment practices were safe, and staff received the training they required for their role.

Risks to people's health, safety and well-being were assessed and care plans were in place to ensure risks were mitigated as much as possible.

Staff were aware of their responsibilities to safeguard people and the home had robust procedures in place.

People received their medicines safely and as prescribed. Medicine management practices were safe.

Staff supported people to access healthcare services when required.

The service was provided in a pleasant and clean environment.

Quality assurance systems were in place to assess, monitor and improve the quality and safety of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding and infection control. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hallaton Manor on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hallaton Manor Ltd is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide accommodation and personal care for up to 41 people and accommodates older people, people with mental health issues, people with learning disabilities and autism, people with alcohol and drugs issues, people with dementia, people with physical disabilities and younger adults. At the time of our inspection there were 36 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report these types of concerns to management.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s right to take risks and become more independent.

There were sufficient staff to support people with their required needs, though staff time was not always available to provide one-to-one time with people.

Effective recruitment processes were in place and followed by the provider. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. Processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were not fully knowledgeable of this guidance but correct processes were in place to protect people.

Staff gained consent before supporting people. People were encouraged to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people, though more training was needed on people’s health conditions. Staff were also supported by managers through supervisions.

People could make choices about the food and drink they had, and staff gave support when required to enable people to have a balanced diet.

People were supported to see a variety of health professionals when required, including opticians and doctors, to make sure they received healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where able and appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained. Care plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests.

There was a complaints procedure which was accessible. A system was in place to respond to complaints appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below.

Hallaton Manor is a service that provides accommodation for up to 41 people. There were 39 people who used the service at the time of these inspections. The service is set on two levels and had a lift and stairs for access. There was a large garden area and the property is in the centre of farm land , so therefore offers extensive field views for people to enjoy.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us that they felt safe at the Hallaton Manor and, in the main, systems and routines supported the safety of people. Medication was stored and recorded in line with guidelines, however, staff were often interrupted during the administration of medicines. This posed a potential risk of a medication error occurring during this time.

The records we reviewed showed that risks associated with people’s care and support had been assessed and actions had been taken to minimise such risks.

People’s needs were assessed prior to them moving into the service and plans of care were developed from this initial assessment. People were involved in decisions about their care and support.

People had been involved in making day to day decisions about their care and support. People also felt that there were currently enough members of staff on duty to meet their care and support needs. People visiting the service also confirmed this.

Staff knew about the needs of the people that they supported and people had access to specialist healthcare advice, when they needed it.

Whilst there were times when we observed people being treated in a kind and caring manner, there were other times when they were not.

Checks had been carried out when new members of staff had been employed. This was to check that they were suitable to work at the service. The staff team had received training relevant to their role within the service and ongoing support had been provided.

Staff meetings and meetings for people who used the service and their relatives were regularly held. This provided people with the opportunity to be involved in how the service was run.

The staff team felt supported by the manager and senior members of staff. They also felt able to speak out about any concern they may have had of any kind.

People’s nutritional and dietary requirements were assessed and a balanced diet was provided, with a choice of meal at each mealtime. Monitoring charts used to monitor people’s food and fluid intake were maintained when these were needed. Whilst the majority of people had a good experience at meal times, We found that some people who did not.

There were systems in place to regularly monitor the service that was provided and these had been effective in the identification of areas that required any action. Any required actions had been planned, monitored and the outcomes recorded

Below is a summary of what we found. The summary describes what people using the service and the staff told us and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. Staff knew about risk management plans and told us about how they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Policies and procedures were in place to make sure that people's medicines were

managed in a safe way.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. The premises and equipment were well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

People's health and care needs were assessed and a care plan was in place for each assessed need. People said they received the care and support they required. One person said 'The staff are alright here, it's clean, I feel safe and I'm well fed. What more could I want?'

Staff had received the training they required to meet people's needs and keep them safe.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'Oh yes, you can always shout for a worker and they'll come if you need anything. Always helpful, always kind'.

People were enabled to maintain relationships with people who were important to them. One person was regularly taken out to visit their family member.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The provider had its own adapted minibus, which helped to keep people involved with their local community.

People knew how to make a complaint if they were unhappy. We saw that the registered manager spent time speaking with people who used the service and their relatives throughout the day during our visit.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Staff were responsive to people's cultural and religious needs. People were able to attend their places of worship and were supplied with culturally appropriate food.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We saw that staff interacted with people who used the service in a positive and respectful way. Staff communicated effectively and demonstrated a good knowledge and understanding of people's individual needs. People were occupied and engaged in activities that were meaningful to them.

People told us they liked the meals provided. We saw that where there was a risk of poor nutrition, people were supported to receive adequate nutrition and hydration.

Recruitment procedures were robust and pre employment checks were carried out. An on going progamme of quality assurance was in place and this included seeking the views of people who used the service.